Evidence map›Paper›PMID 32026802›Full record

SynthesisJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2020

Effects of respiratory muscle therapy on obstructive sleep apnea: a systematic review and meta-analysis.

Brien Hsu, Chitra Priya Emperumal, Vincent X Grbach, Mariela Padilla, Reyes Enciso

2 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 30 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 6 pooled it
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05210998 nacompletednot on this mapstarted 2022, after this paper: background citation

Investigation of the Effects of Respiratory Muscle Training Combined With Aerobic Exercise in Persons With Obstructive Sleep Apnea Syndrome

TypeinterventionalSponsorIstanbul University - CerrahpasaRan2022 to 2023Enrolled36ConditionsObstructive Sleep Apnea SyndromeArmsGradual Aerobic exercise training AND Respiratory muscle training, Gradual Aerobic exercise training
NCT05678088 naactive not recruitingnot on this mapstarted 2023, after this paper: background citation

Strengthening Oropharyngeal Muscles as a Novel Approach to Treat Obstructive Sleep Apnea: A Randomized Feasibility Study

TypeinterventionalSponsorSunnybrook Health Sciences CentreRan2023 to 2027Enrolled45ConditionsObstructive Sleep ApneaArmsOropharyngeal Exercises, Sham Exercises
3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 6 syntheses or guidelines pooled it, 79 citations in OpenAlex.

  1. Pooled it
  2. Effects of aerobic exercise and resistance training on obstructive sleep apnea: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
    Pooled it
  3. Assessment and rehabilitation of tongue motor skills with myofunctional therapy in obstructive sleep apnea: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. [Effects of orofacial myofunctional therapy on postoperative outcomes of upper airway surgery for adults with severe obstructive sleep apnea].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2022
    Trial
  9. Article
  10. Article
  11. Review
  12. Steam-assisted respiratory muscle training may improve sleep quality in mild-to-moderate obstructive sleep apnea: a pilot polysomnography study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
    Article
  13. Article
  14. Article
  15. Review
  16. Exploring Exercise Interventions for Obstructive Sleep Apnea: A Scoping Review.Journal of functional morphology and kinesiology · 2025
    Review
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Brien HsuMaster of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California.
Chitra Priya EmperumalMaster of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California.
Vincent X GrbachDepartment of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, California.
Mariela PadillaDivision of Periodontology, Diagnostic Sciences and Dental Hygiene, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California.
Reyes EncisoDivision of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California.
University of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesThe purpose of this study is to conduct a systematic review and meta-analysis evaluating the effects of respiratory muscle therapy (ie, oropharyngeal exercises, speech therapy, breathing exercises, wind musical instruments) compared with control therapy or no treatment in improving apnea-hypopnea index ([AHI] primary outcome), sleepiness, and other polysomnographic outcomes for patients diagnosed with obstructive sleep apnea (OSA).

methodsOnly randomized controlled trials with a placebo therapy or no treatment searched using PubMed, EMBASE, Cochrane, and Web of Science up to November 2018 were included, and assessment of risk of bias was completed using the Cochrane Handbook.

resultsNine studies with 394 adults and children diagnosed with mild to severe OSA were included, all assessed at high risk of bias. Eight of the 9 studies measured AHI and showed a weighted average overall AHI improvement of 39.5% versus baselines after respiratory muscle therapy. Based on our meta-analyses in adult studies, respiratory muscle therapy yielded an improvement in AHI of -7.6 events/h (95% confidence interval [CI] = -11.7 to -3.5; P ≤ .001), apnea index of -4.2 events/h (95% CI = -7.7 to -0.8; P ≤ .016), Epworth Sleepiness Scale of -2.5 of 24 (95% CI= -5.1 to -0.1; P ≤ .066), Pittsburgh Sleep Quality Index of -1.3 of 21 (95% CI= -2.4 to -0.2; P ≤ .026), snoring frequency (P = .044) in intervention groups compared with controls.

conclusionsThis systematic review highlights respiratory muscle therapy as an adjunct management for OSA but further studies are needed due to limitations including the nature and small number of studies, heterogeneity of the interventions, and high risk of bias with low quality of evidence.

Indexed as

Sleep Apnea, ObstructiveAdultChildContinuous Positive Airway PressureHumansOropharynxRespiratory MusclesSnoringapnea-hypopnea indexbreathing exercisesmyofunctional therapyobstructive sleep apneaoropharyngeal exercisesrespiratory muscle therapyspeech therapy

Identifiers

PMID32026802
PMCPMC7849810
OpenAlexW3005007310

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.